Bush allies urge him to sign children’s bill

The Senate, by a wide margin, approved a bill Thursday to expand health insurance for children of low-income working parents, sending it to President Bush as supporters mounted a last-ditch effort to persuade him not to cast a long-threatened veto.

The 67-29 vote was just enough to approve the bill over the president’s objections; the House is about 25 votes short of the two-thirds majority required for an override. So the bill’s supporters, including some Republicans, are stepping up their appeals to Bush.

The American Medical Assn. and AARP, the seniors lobby -- key Bush allies in the creation of the Medicare prescription benefit -- wrote the president Thursday urging him to change his mind and sign what they called a “carefully crafted bipartisan compromise.”

On the Senate floor, some of the sharpest challenges to Bush’s position came from Republicans. The bill’s GOP supporters said the administration was misinformed -- and even misleading the public -- when it argued that the bill’s provisions for extending aid upward to families far from the poverty line would put the nation on a slippery slope toward socialized medicine.

“The administration is threatening to veto this bill because of ‘excessive spending’ and their belief that this bill is a step toward federalization of healthcare,” said Sen. Pat Roberts (R-Kan.), a supporter of the plan. “I am not for excessive spending and strongly oppose the federalization of healthcare. And if the administration’s concerns with this bill were accurate, I would support a veto. But, bluntly put, they are not.”

Reflecting the heated nature of the debate, Sen. Michael D. Enzi (R-Wyo.), who supports the president’s position, said in a statement: “We shouldn’t create a new federal entitlement and we shouldn’t be laying the foundation for Castro-style healthcare, which Americans don’t want.”

At issue is the State Children’s Health Insurance Program, a federal-state partnership that provides coverage to some 6 million children, 800,000 of them in California. Congress wants to spend $60 billion on the program over the next five years, enough to cover an additional 3 million to 4 million children, including some whose parents earn substantially more than present eligibility rules permit. About 9 million children are uninsured nationwide.

The expansion would be paid for with a stiff boost in tobacco taxes.

Bush has proposed spending $30 billion on the program, which independent analysts say is not enough to maintain the current caseload. The president is also concerned that the bill would allow states to cover uninsured middle-class children whom he says belong in private plans.

With legal authority for the program set to expire Sept. 30, the Health and Human Services Department has been calling states this week to discuss scenarios in which funding may be interrupted. But Congress has included a six-week extension in a temporary government funding bill Bush is expected to sign.

State officials say they need permanent renewal of the program to be able to properly budget for it or else the uncertainty could result in children losing their current coverage.

Responding to the administration’s criticism during Thursday’s debate, Roberts pointed out that legislation originally passed by the House would have increased program spending to $75 billion. “We had to find a middle ground,” he said. Senate Republicans insisted on spending no more than $60 billion.

Bush, during a news conference last week, said the congressional bill would take a program meant to help poor children and turn it into one that covered children in households making up to $83,000.

Said Roberts: “I just have to ask the speechwriter, Are you reading the same bill I am? You can twist the facts, but facts are stubborn things.”

States can seek changes to income eligibility rules, subject to administration approval; only one state, New York, has suggested expanding coverage to families making as much as $80,000. Others are talking about raising the limit to no more than $60,000. Most states are not contemplating changes. States that offer coverage to middle-class families require them to pay a portion of the premium.

The bill’s supporters said the administration would retain the authority to deny requests it considered out of line. And the bill would sharply restrict federal funding for any coverage expansion aimed at families making more than three times the federal poverty level, about $60,000 for a family of four.

An Urban Institute analysis estimated that about 80% of the children who would gain coverage under the congressional bill are in families making less than $40,000.

Republican Sens. Charles E. Grassley of Iowa and Orrin G. Hatch of Utah have also complained that the administration is misrepresenting the bill as a middle-class program.

White House spokesman Tony Fratto suggested that the administration might be open to spending more on the program, if expansion of eligibility was curbed.

“This should not be an issue where you decide what the funding is, and then [set] the policy,” Fratto said. “We should decide what the policy is and let the funding land where it lands.”

But, Fratto said, once a government program subsidizes people making three times the poverty level or more, “you are talking about people who are solidly within the middle class of America, and you are extending another unfunded entitlement to the middle class.”

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ricardo.alonso-zaldivar @latimes.com